Provider Demographics
NPI:1275729105
Name:MAULDIN CHIROPRACTIC
Entity Type:Organization
Organization Name:MAULDIN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAULDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:828-355-9052
Mailing Address - Street 1:240 SHADOWLINE DR
Mailing Address - Street 2:A
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5088
Mailing Address - Country:US
Mailing Address - Phone:828-355-9052
Mailing Address - Fax:
Practice Address - Street 1:240 SHADOWLINE DR
Practice Address - Street 2:A
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5088
Practice Address - Country:US
Practice Address - Phone:828-355-9052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty